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[{"$nulls":24},"経営事項審査申請用"]
[]
[]
["建設業退職金共済事業加入 ・ 履行証明願"]
[]
[null,"共済事業加入及び共済契約の履行状況を下記により証明願います。"]
[{"$nulls":21},"令和",null,null,"年",null,"月",null,"日"]
[]
[]
[null,"独立行政法人   勤労者退職金共済機構"]
[]
[null,"建退共山口県支部長",{"$nulls":8},"殿"]
[]
[{"$nulls":5},"住所"]
[null,"申請者",null,null,null,"名称"]
[null,"（共済契約者）",null,null,null,"代表者",{"$nulls":19},"㊞"]
[{"$nulls":5},"電話番号"]
[]
["①","共済契約成立年月日",null,null,null,"昭和\n平成\n令和",null,"年",null,"月",null,"日",null,null,"⑧","事務受託者番号"]
[]
[]
["②","共済契約者番号",null,null,null,"８５",{"$nulls":8},"⑨","決算日及び決算期間"]
[{"$nulls":6},"‐",{"$nulls":10},"年",null,"月",null,"日","～",null,null,null,"年",null,"月",null,"日"]
[]
["③","直前決算日における\n被　 共　 済   者   数",{"$nulls":12},"⑩","工事施工高"]
[]
[{"$nulls":11},"人",{"$nulls":6},"（土　木）",{"$nulls":5},"(建築・その他）"]
["④","直前決算日における直近１か年間の\n手   帳   更   新   数"]
[{"$nulls":15},"公共工事",{"$nulls":6},"千円",{"$nulls":6},"千円"]
[{"$nulls":11},"冊"]
[]
[]
["⑤","直前決算日における直近１か年間の\n証   紙   購   入   額",{"$nulls":13},"民間工事",{"$nulls":6},"千円",{"$nulls":6},"千円"]
[{"$nulls":11},"円"]
[{"$nulls":16},"合　　計",{"$nulls":11},"千円"]
["⑥","直前決算日における直近１か年間の\n元請から現物で交付を受けた証紙の金額",{"$nulls":12},"⑪","その他"]
[{"$nulls":11},"円"]
[]
["⑦","直前決算日における直近１か年間の\n下請へ現物で交付をした証紙の金額"]
[{"$nulls":11},"円"]
[]
[]
["建設業退職金共済事業加入 ・ 履行証明書"]
[]
[null,"      上記のとおり相違ないことを証明します。"]
[]
[null,"証  第",null,null,null,"号"]
[]
[null,"令　和","年","月",null,"日"]
[]
[{"$nulls":10},"独立行政法人　　勤労者退職金共済機構"]
[]
[{"$nulls":10},"建退共山口県支部"]
[]
[{"$nulls":14},"支部長",{"$nulls":12},"㊞"]

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